Интегрированный способ лечения синдрома хронической тазовой боли у женщин с воспалительными заболеваниями органов малого таза

Abstract

The article presents the role of pro- and anti-inflammatory cytokines in the process of chronic pelvic pain (CPP) in women with pelvic inflammatory disease; therapeutic treatment for the prevention of relapse and psychological disorders. The objective: to determinate the role of the pro - and anti-inflammatory cytokines into the implementation of chronic pelvic pain syndrome (CPP) and to measure the performance of treatment which including pathophysiological factors of the woman’s pain with pelvic inflammatory disease Patients and methods: The study involved 75 women with PID. The main group consisted of 40 women with CPPS, Group 2 – 35 patients with painless passage of (the comparison group). The assessment of pain using a visual analogue scale (VAS); Pain Questionnaire McGill; conducted psychological testing, determined by the content of cytokines (IL-10, IL-6, TNF-a) in the blood serum. Results. Significantly elevated levels of TNF-a in the celebrated in the first group compared with the second (p<0.001), which is directly correlated with the duration of CPPS (r=0.422; p<0.001), the intensity of pelvic pain VAS (r=0.469; p<0.001), as well as moderate and severe symptoms of depression degree (r=0.333; p<0.05). Conclusions. The therapeutic treatment what we offered contributed to the regression of the pain after 1 month as determined by VAS 45.3±1.4 mm and 3 months 31.3±1.4 mm; reduction of reactive anxiety and depressive disorders detected in 84.7% of patients; improving psycho-emotional and general condition, normalization of sleep observed in 88.3% of women. Key words: inflammatory diseases of the pelvic organs, chronic pelvic pain, cytokines, personal anxiety.